NEJM: Trial of A Monoclonal Antibody to PACAP for Migraine Prevention

Posted on by

PainRelief.com Interview with:
Professor Messoud Ashina, MD, PhD, DMSc
Department of Neurology and Danish Headache Center
Glostrup Hospital
University of Copenhagen, Glostrup
Copenhagen, Denmark

PainRelief.com: What is the background for this study?

Background and Main Findings: Current migraine treatments targeting CGRP aren’t fully effective for everyone. PACAP is another key molecule implicated in migraine and can trigger migraine attacks. Lu AG09222, an antibody that blocks PACAP, has shown promise in reducing migraine days in a phase 2a trial.

Effects Duration: 4 weeks.

Pages: 1 2

Mindfulness-Based Interventions Delivered via Telehealth Improved Pain and Well-Being Among People with Chronic Pain

Posted on by

PainRelief.com Interview with:
Diana Burgess, PhD
Director of the VA Advanced Fellowship Program in Health Services Research
CCDOR: Center for Care Delivery and Outcomes Research
Director of the VA QUERI Complementary and Integrative Health Evaluation Center (CIHEC)
Professor of Medicine at the University of Minnesota

PainRelief.com: What is the background for this study?

Response: Mindfulness is being aware and paying attention in a kind, non-judgmental way, to what is happening in the present moment. Mindfulness-based interventions teach people mindfulness skills, through a variety of practices, such as meditation and mindful movement. Although mindfulness interventions are evidence-based treatment for chronic pain and conditions that often accompany pain, like anxiety and depression, many MBIs are difficult to implement at scale in healthcare systems as they require trained mindfulness instructors, dedicated space and pose barriers to patients due to the time commitment involved. We wanted to develop MBIs that were relatively low resource, scalable and more accessible for patients. 

Pages: 1 2

Study Finds Sex Bias in Pain Management in Emergency Departments

Posted on by

PainRelief.com Interview with:
Mika Guzikevits
Doctoral Student
Prof. Choshen-Hillel’s Decision-Making lab
School of Business Administration & Federmann Center for the Study of Rationality 
The Hebrew University of Jerusalem

PainRelief.com: What is the background for this study?

Response: Although pain is one of the most common reasons for seeking medical help, providing adequate treatment can be challenging due to its subjective nature. When healthcare providers’ pain management decisions rely on subjective judgment, they are susceptible to biases.

PainRelief.com: What are the main findings?

Response: Our study, which analyzed over 21,000 patient records from the United States and Israel, found a significant sex bias in pain management at emergency departments. We found that female patients are consistently less likely to receive pain relief prescriptions compared to male patients with similar complaints (around 10% difference). This bias persists across different ages, pain levels, and physician sex, indicating a systemic issue. Female patients’ pain scores are less frequently recorded, and they spend more time in the emergency department than male patients. In a controlled experiment involving 109 nurses, we found that pain was rated as less intense if the patient was said to be female rather than male, which supports our hypothesis that healthcare providers are susceptible to stereotypical beliefs about women’s pain and expect them to act “hysterically” and exaggerate their pain reports.

Pages: 1 2

UNC Scientists Identify Specific Brain Circuits Mediating Placebo Pain Relief

Posted on by

PainRelief.com Interview with:
Grégory Scherrer, PharmD, PhD
University of North Carolina at Chapel Hill
Depts of Cell Biology and Physiology, of Pharmacology
UNC Neuroscience Center

PainRelief.com: What is the background for this study?

Response: The placebo effect is a fascinating phenomenon where a person’s positive expectations can lead to real changes in their physical or psychological state, even without active treatment. A specific aspect of this phenomenon is placebo analgesia, where the expectation of pain relief results in an actual reduction in pain perception. Placebo analgesia demonstrates the intricate power of the human brain that can be harnessed for pain control. However, despite extensive research, the neural mechanisms underlying placebo analgesia remain largely unclear.

Our study aimed to explore the neural circuits mediating placebo analgesia, using an innovative mouse model to mimic the human placebo analgesia. By doing so, we hoped to uncover how certain brain regions interact to produce pain relief through expectation alone, potentially opening new avenues for pain control by manipulating these circuits.

Pages: 1 2

VA Evaluates Use of Massage Therapy for Pain Relief

Posted on by

PainRelief.com Interview with:
Dr. Selene Mak Ph.D, MPH
Program Manager in the Evidence Synthesis Program
VA Greater Los Angeles Healthcare System

Dr. Selena Mak
Dr. Selena Mak

PainRelief.com: What is the background for this study?

Response: The Department of Veterans Affairs is committed to providing evidence-based treatments.  One way VA pursues this is through rigorous examinations of the evidence about potential therapies.  Massage therapy is one such therapy being examined. 

VA previously produced an evidence map of massage therapy for pain, which included systematic reviews published through 2018. However, new evidence is constantly appearing and to categorize the newer evidence base for use in decision-making by policymakers and practitioners, VA policymakers requested a new, updated evidence map of systematic reviews published since 2018 to answer the question “What is the certainty of evidence in systematic reviews of massage therapy for pain?”

Pages: 1 2

Experimental “bitopic” Opioid Suppresses Pain With Fewer Side Effects

Posted on by

PainRelief.com Interview with:

Susruta Majumdar, PhD
Professor in the Department of Anesthesiology
Washington University School of Medicine
Nokomis Ramos-Gonzalez, PhD
Postdoctoral Trainee in the Majumdar Lab
Washington University School of Medicine
Balazs R. Varga PhD
Center for Clinical Pharmacology
University of Health Sciences & Pharmacy at St. Louis
Department of Anesthesiology and Washington University Pain Center
Washington University School of Medicine
St. Louis, Missouri 63110

Jay McLaughlin, Ph.D
Professor of Pharmacodynamics
College of Pharmacy
University of Florida

PainRelief.com: What is the background for this study?

Response:    Opioid medications tap into the body’s natural system for mitigating pain by activating pain-suppressing opioid receptors on neurons. Although meant to help, sometimes these medications do harm.  Opioid medications offer people relief from debilitating pain, but these drugs come with dangers: the risk for addiction, miserable withdrawal symptoms and the potential for fatal overdose.  New mechanistic insights into the function and regulation of the opioid receptors present the opportunity to design new, safer opioid painkillers. The team’s previous research utilized a strategy to design functionally selective “bitopic” opioids by targeting the sodium binding allosteric site in the opioid receptor.

Pages: 1 2

Gene Linked to Efficacy of Gabapentin for Chronic Pelvic Pain Identified

Posted on by

PainRelief.com Interview with:
Dr Lucy ​H R Whitaker (BSc (Hons) MB ChB MSc MD MRCOG)
Senior Clinical Research Fellow and Honorary Consultant Gynaecologist
Centre for Reproductive Health,
Institute for Regeneration and Repair 
Edinburgh BioQuarter 
Edinburgh 

PainRelief.com: What is the background for this study?

Response: Our study focused on chronic pelvic pain in women, a common condition affecting up to one in four women, for which there are few evidence-based treatment options. We previously conducted a multicentre randomised controlled trial (GaPP2) to assess the effectiveness of gabapentin, a commonly prescribed painkiller, in relieving chronic pelvic pain.

The trial found that gabapentin did not relieve pain and was associated with more side effects compared to a placebo. However, to better understand why some women respond to gabapentin more than others, we studied the DNA of the participants from the GaPP2 trial to identify genetic changes that might affect response to gabapentin.

Pages: 1 2

Fibromyalgia: Smartphone Delivered CBT Therapy Reduced Symptoms and Enhanced Well-Being

Posted on by

PainRelief.com Interview with:
Mike Rosenbluth, PhD
CEO, Swing Therapeutics
UCSF Rosenman Innovators Program
San Francisco, CA

PainRelief.com: What is the background for this study?

Response: Fibromyalgia is a chronic pain condition that affects an estimated 10 million Americans, characterized by widespread pain and other physical and cognitive symptoms that include fatigue, disrupted sleep, reduced physical function, memory problems and difficulty concentrating (“brain fog”). Clinical guidelines recommend multimodal treatment that combines medication management with non-drug approaches including cognitive behavioral therapy (CBT), but only 5% of fibromyalgia patients annually end up receiving some form of CBT due to lack of trained providers or cost. 

There have been dozens of studies on CBT for management of chronic pain or fibromyalgia specifically. The majority of these studies are small, are testing an intervention that cannot scale, and are run at a single site. These studies ultimately conclude that more research should be done. We aimed to develop a product that could deliver behavioral therapy for fibromyalgia at scale and test that product in a rigorous study that was powered to demonstrate definitive clinical benefit of the treatment.

Stanza is a self-guided, smartphone-based digital therapy that delivers acceptance and commitment therapy (ACT), a type of CBT.  In this multi-center, randomized controlled trial, 275 participants were randomized to receive either Stanza treatment or an active control intervention (in this case a digital symptom tracker and access to health education). 

Continue reading →

CMAJ Study Suggests Clinicians Adapt Opioid Prescriptions to Specific Types of Acute Pain

Posted on by

PainRelief.com Interview with:
Raoul Daoust MD CSPQ MSc
Professeur titulaire/ full professor
Département Médecine de Famille et Médecine d’Urgence
Université de Montréal
Clinicien chercheur / Clinician Researcher
Médecine d’Urgence / Emergency Medicine
CEMU-HSCM (Centre d’Étude en Médecine d’Urgence)
SCEM-HSCM (Study Center in Emergency Medicine)
Hôpital Sacré-Coeur de Montréal
CIUSSS Nord-de-l’ile

PainRelief.com: What is the background for this study?

Response: Overprescribing is linked to opioid misuse and overdose, with household supplies of opioids associated with an increased risk of overdose as many people do not dispose of unused medications safely. In Canada, more than 7570 people died of opioid overdoses in 2021, and more than 68 000 people died in the United States in 2020 from these same drugs.

Continue reading →

Chronic Pain Conditions Among Women in the Military Health System

Posted on by

PainRelief.com Interview with:
Andrew J. Schoenfeld, MD
Professor, Harvard Medical School
Orthopaedic Surgery
Brigham and Women’s Hospital 

PainRelief.com: What is the background for this study?

Response: The impetus for this research stems from my time as the Director of the Medical Evaluation Board at Fort Bliss Texas during my time on active duty with the Army between 2009-13 and my time in Ann Arbor VA between 2013-15.  We wanted to understand the impact that repeated exposure to the high intensity deployment to combat theaters during 2006-2013  had on women active duty servicemembers and women civilian dependents of active duty servicemembers who were deploying

PainRelief.com: What are the main findings?

Response: Significant increases in the diagnosis of Chronic Pain conditions among women active duty service members as well as women civilian dependents who were affiliated with the military between 2006-13.

Pages: 1 2